Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.
Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.
Arch Phys Med Rehabil. 2018 Dec;99(12):2513-2522. doi: 10.1016/j.apmr.2018.04.025. Epub 2018 May 26.
To investigate interrater and intrarater reliability, measurement error, and convergent and discriminative validity of the Adult Assisting Hand Assessment Stroke (Ad-AHA Stroke).
Cross-sectional observational study.
A total of 7 stroke rehabilitation centers.
Stroke survivors (reliability sample: n=30; validity sample: N=118) were included (median age 67y; interquartile range [IQR], 59-76); median time poststroke 81 days (IQR 57-117).
N/A.
Ad-AHA Stroke, Action Research Arm Test (ARAT), upper extremity Fugl-Meyer Assessment (UE-FMA). The Ad-AHA Stroke is an observation-based instrument assessing the effectiveness of the spontaneous use of the affected hand when performing bimanual activities in adults poststroke. Reliability of Ad-AHA Stroke was examined using intraclass correlation coefficients (ICCs), Bland-Altman plots, and weighted kappa statistics for reliability on item level. SEM was calculated based on Ad-AHA units. Convergent validity was assessed by calculating Spearman rank correlation coefficients between Ad-AHA Stroke and ARA test and UE-FMA. Comparison of Ad-AHA Stroke scores between subgroups of patients according to hand dominance, neglect, and age evaluated discriminative validity.
Intrarater and interrater agreement showed an ICC of 0.99 (95% confidence interval, 0.99-0.99), an SEM of 2.15 and 1.64 out of 100, respectively, and weighted kappa for item scores were all above 0.79. The relation between Ad-AHA and other clinical assessments was strong (ρ=0.9). Patients with neglect had significantly lower Ad-AHA scores compared to patients without neglect (P=.004).
The Ad-AHA Stroke captures actual bimanual performance. Therefore, it provides an additional aspect of upper limb assessment with good to excellent reliability and low SEM for patients with subacute stroke. High convergent validity with the ARA test and UE-FMA and discriminative validity were supported.
调查成人辅助手评估卒中（Ad-AHA 卒中）的评分者间信度、评分者内信度、测量误差、以及聚合效度和区分效度。
横断面观察性研究。
共有 7 家卒中康复中心。
纳入卒中幸存者（信度样本：n=30；效度样本：N=118）（中位数年龄 67 岁；四分位距[IQR]，59-76 岁）；卒中后中位数时间 81 天（IQR，57-117 天）。
无。
Ad-AHA 卒中、动作研究手臂测试（ARAT）、上肢 Fugl-Meyer 评估（UE-FMA）。Ad-AHA 卒中是一种观察性工具，用于评估卒中后成人在进行双手活动时，受影响的手自发使用的有效性。使用组内相关系数（ICC）、Bland-Altman 图和项目水平的加权 Kappa 统计来评估 Ad-AHA 卒中的信度。基于 Ad-AHA 单位计算 SEM。根据手优势、忽略和年龄将患者分为亚组，计算 Ad-AHA 卒中与 ARAT 测试和 UE-FMA 之间的 Spearman 秩相关系数，以评估聚合效度。比较忽略患者和非忽略患者的 Ad-AHA 卒中评分，以评估区分效度。
评分者内和评分者间的一致性显示 ICC 分别为 0.99（95%置信区间，0.99-0.99）、SEM 分别为 2.15 和 1.64 分（占 100 分），项目得分的加权 Kappa 均大于 0.79。Ad-AHA 与其他临床评估的相关性较强（ρ=0.9）。有忽略的患者的 Ad-AHA 评分明显低于无忽略的患者（P=.004）。
Ad-AHA 卒中可捕捉实际的双手表现。因此，它为亚急性卒中患者的上肢评估提供了额外的方面，具有良好到极好的信度和低 SEM。与 ARAT 测试和 UE-FMA 具有高度的聚合效度和区分效度。
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